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When a significant amount of money is invested in something, the risk of fraud typically increases. Which is why it comes as no surprise that a scheme as financially big as the NDIS has been the talk of the town when it comes to fraud and compliance. So, what can we expect when it comes to fraud, compliance, and red flags to watch out for? Fraud vs non-compliance Fraud is considered to be a specific and intentional crime involving individuals or organisations falsely claiming to provide services to NDIS participants or inflating their services' costs. Whereas non-compliance can lead to mistakes when it comes to adhering to the regulations and standards set by the scheme for providing services to participants. Compliance ensures that participants receive quality services that meet their needs while avoiding fraudulent activities. It’s essential to maintain a balance between NDIS compliance and fraud prevention to ensure the scheme's success and the well-being of its participants. NDIS Crackdown It was recently announced by the NDIS Minister Bill Shorten, that the NDIS is set to go through a reboot aimed at improving the quality of services and support provided to people with disabilities, reducing bureaucratic red tape, and making it easier for people to access the NDIS. One of the key policy directions that has been laid out is to eliminate unethical practices. Essentially this means continuing the crackdown against fraud and unethical behaviour. The term ‘fraud crackdown’ is nothing new to the NDIS, with the fraud taskforce having been in full swing since being established by the Australian government in 2018 to tackle fraud and abuse of the NDIS. The aim of the taskforce is to identify and investigate instances of fraud, particularly those related to fraudulent claims made by NDIS providers or participants. The taskforce’s work includes analysing data to identify potential fraud, conducting investigations, and prosecuting cases where appropriate. They also work to raise awareness of fraud and abuse in the NDIS and provides education and guidance to participants, families, and providers about how to prevent fraud and report suspicious activity. Red flags to watch out for As a participant, there are some red flags you can be on the lookout for to help protect yourself against fraud, including: #1 Refusing service agreements The best protection from criminal activity or shady providers is to have a written contract in place that can protect you if things go wrong. It’s always a good idea to talk with your providers about setting up a service agreement. It’s important to note that only NDIS registered providers are required to have a service agreement in place. So, if a provider isn’t NDIS registered, not having a service agreement isn’t necessarily red flag worthy. However, if a provider (registered or non-registered) actively discourages or refuses to set up a service agreement, that can be considered a red flag. After all, having a service agreement in place benefits both providers and participants. #2 Making changes Making unexpected changes to your supports or services that hasn’t been discussed with you or isn’t listed in your service agreement can be a red flag. If an unexpected change has occurred, talk with your provider first to determine why the change was made without discussion. If you still have concerns, speak with your support coordinator, plan manager or LAC to determine next steps. #3 Asking too much about your funding Now, it’s not completely out of the ordinary for a provider to ask questions about your funding. Providers do need to be confident that they will be paid for their work. However, if a provider wants to know how much funding you have before they have discussed your support needs to draw up any agreements or quotes… this is a potential red flag. The NDIS does not recommend sharing specific budget details with providers. If a provider has a question regarding funding, normally it might be to check that there is funding available for their supports and services and maybe how many hours of funding you potentially have – not a dollar amount. Tips for compliance When it comes to compliance, there are three major tips that can help keep you on the right path. They are: Keep records of all documentation including reports, medical records, copies of your previous plans, essentially any documentation relevant to your disability and NDIS plan. Ensure all invoices and receipts align with NDIS requirements. If you are plan managed by us, we can help keep track of service agreements and your invoices. How we can help Our goal is to help participants exercise their choice and control over invoicing, including being able to approve or reject invoices where necessary, and being able to easily access a real-time review of their budgets and previously paid invoices. You can maintain maximum choice and control through our flexible invoice payment options. If you ever have concerns about fraudulent activity, especially relating to your invoices, reach out to our team on 1300 233 273 or email support@first2care.com.au.

Have you ever noticed a charge for non-face-to-face supports listed on a provider invoice and wondered… what’s that? You’re not alone. Non-face-to-face supports are on the rise, which means it’s time to take a deep dive to help you better understand this support option, what can and cannot be charged, and the benefits of non-face-to-face supports. Understanding non-face-to-face supports Non-face-to-face supports refer to services that are provided remotely, including: Telehealth services - virtual medical consultations that allow participants to receive healthcare advice and treatment from a licensed healthcare professional via video conferencing. Online training programs - training programs that can be accessed online, helping participants acquire skills and knowledge necessary to manage their NDIS plans. Plan management services - services that can be provided remotely, covering tasks such as managing NDIS payments and liaising with service providers. Remote therapy services - therapy sessions that can be conducted remotely, typically through video conferencing. Assistive technology support - equipment-based supports that assist participants to live more independently. Deciding on the most appropriate equipment can be done via phone or email. Over the past few years, these supports have become more frequently utilised by NDIS participants to access timely and cost-effective provider services despite not being physically present. Non-face-to-face supports can be particularly useful for participants who live in remote or rural areas or have mobility issues, making it difficult to access support in-person. Non-face-to-face supports… what can and cannot be charged? Non-face-to-face supports can include: Report-writing Guidance and advice Assessments Planning and coordination of services Non-face-to-face supports should not include: Processing NDIS claims Training and supervising staff Service agreement development Additional NDIS requirements: NDIS providers can only bill for non-face-to-face supports that have been approved and funded by the NDIS NDIS providers should ensure that the cost of non-face-to-face supports is within the approved budget for the participant's NDIS plan NDIS providers should comply with the NDIS rules and guidelines on billing and claiming for non-face-to-face supports What are the benefits of non-face-to-face supports? Non-face-to-face supports have several benefits, including: Increased accessibility: by offering non-face-to-face supports providers can reach more participants across Australia. Flexibility: With non-face-to-face support options, providers can deliver services at a time that is convenient for them, rather than needing to schedule an in-person appointment during business hours. Reduced costs: Without the need for physical premises or travel, non-face-to-face support services can be more cost-effective for providers to deliver. Improved outcomes: Regular and ongoing non-face-to-face communication and support can help to improve participant outcomes by providing ongoing monitoring and support. Personalisation: With the use of various technologies, non-face-to-face support services can be personalised to meet specific needs. Providers charging for non-face-to-face supports An NDIS provider can charge for non-face-to-face supports if they are reasonable and necessary according to a participant's NDIS plan. Provider should list non-face-to-face supports in a service agreement including the terms and conditions of charging for non-face-to-face supports. Providers cannot charge for non-face-to-face supports unless the support has been delivered. If you notice a non-face-to-face support listed in a provider invoice, and you’re unsure of the charge you can contact our support team to request the invoice be on hold while you discuss the charge with your provider. Read more about the benefits of working with an independent, professional Plan Manager. Alternatively, contact our friendly team on 1300 322 273 or support@first2care.com.au.

There has been a lot of uncertainty within the disability community over the past few months with one major question lingering in most people’s minds… “will there be budget cuts?” Although this can be scary and stressful to talk about, it’s definitely better to be up-to-date and in the know when it comes to the latest NDIS news, especially in light of the recent NDIS reboot announcement and May Budget release. Which is why we’re here to help break it all down and answer some commonly asked questions based on the information available. NDIS is here to stay! The good news is that the NDIS isn’t going anywhere… but it will be getting a reboot. NDIS Minister Bill Shorten recently stated, 'To enable the NDIS to reach its potential, we need to – in essence – reboot.' And that is exactly what is set to happen… a full NDIS reboot. We understand that part of this reboot is for the NDIS to be more realistic with its own projection of how many new entrants there will be onto the scheme. An estimate that has been voiced is that it was overstated by approx. 120,000 people, which represents a significant portion of the cost saving, due to incorrect numbers being previously used for a different narrative. Having the NDIS go through a reboot isn’t a bad thing. In fact, if done right it could have a really positive outcome for participants. The reboot aims to reform measures for improving the quality of services and support provided to people with disabilities, reducing bureaucratic red tape, and making it easier for people to access the NDIS. To ensure the reboot is heading in the right direction, a panel of experts including Bruce Bonyhady and Lisa Paul conducted an independent review last October, to address the design, operations, and sustainability of the Scheme. At this stage, six key policy directions have been outlined: NDIS workforce Long-term planning Spiralling expenses Better outcomes from SIL Eliminate unethical practices Increase community and mainstream supports For more information on the six policy directions, click here. Cost of the NDIS on the rise The rising cost of the NDIS has been all over the media lately, so it’s no secret that this is an issue the government is wanting to combat. It was recently released that the actual expense for 2022-2023 came in as $36.9bn, alongside future forecasts. Currently included the future forecasts is a $910m estimated budget to help improve the NDIS. This includes: $429m to improve NDIA capabilities and systems $73.4m to support participants to manage their plans $56.4m to improve Supported Independent Living (SIL) decisions $29.3m to ensure supports provided to participants are evidence-based $48.3m to crackdown on fraud and non-compliance Of course, there are other areas the proposed funding will go with the intent to improve the capabilities and sustainability of the scheme, including two proposed pilot which are: A pilot for blended payments where paying providers is partly based on the outcomes achieved, not just the time spent delivering services A pilot for a new approach to reach remote and First Nations communities When it comes to improvements to the NDIS, it’s important that there is careful consideration to co-design with participants and providers being part of the discussion so implemented changes have a positive impact on the quality of services and participant safety. Flattening the curve Following a National Cabinet meeting on 28th April 2023, the intention to reduce NDIS growth by 8% per year by July 2026 (from the current 14%) was announced. However, how they would meet that target was not addressed. For many NDIS participants, this is where the question comes in… “will my funding be cut?” At this stage, no. If your funding is considered reasonable and necessary, the NDIA won’t cut your NDIS plan. However, eligibility for NDIS funded supports is set to tighten in a bid to save $15bn across the next four years. NDIS Minister Bill Shorten has stated that, “the scheme was never designed for every Australian with a disability but for the most severely and profoundly impaired.” The intent is to call on states and territories to step up their own services for people with disability so that the scheme is not “the only lifeboat in the ocean”. Another avenue the NDIS Minister has been particularly fierce on is fraud. “We also intend to clamp down on unethical behaviour,” he said. “That covers everything from the crims to people overservicing, to people overcharging.” Although there has certainly been some debate as to the real cost and frequency of fraud that is occurring in relation to the NDIS, it can occur and it’s important for participants and providers to protect themselves from fraud. If you do suspect someone of fraud, you should report it to the NDIS by: Calling the NDIS Fraud Reporting and Scams Helpline on 1800 650 717 Emailing fraudreporting@ndis.gov.au New Price Guide Each year the NDIS releases a new Pricing Arrangements and Price Limits (formerly Price Guide) which outlines the cost of supports that can be covered under the NDIS. It provides a detailed breakdown of the maximum prices that NDIS providers can charge for their services, along with the price limits that apply to ensure prices remain reasonable and affordable for participants. The NDIS pricing arrangements and price limits release 2023 includes the following key features: Price limits: The release sets maximum price limits for different types of supports under the NDIS scheme, ensuring participants are not charged more than the allowable amount for the services they receive. Increases in prices: The release also includes minor increases in prices for some supports, reflecting the increased cost of delivering services. New support items: The release will add new support items to the NDIS price list, reflecting expanding participant needs and demand. Improved transparency: The release aims to improve the transparency of pricing for NDIS supports, making it easier for participants to understand the cost of services and ensuring providers are accountable for their pricing. The Pricing Arrangements and Price Limits is pending release in June 2023. Read more about the benefits of working with an independent, professional Plan Manager. Alternatively, contact our friendly team on 1300 322 273 or support@first2care.com.au.

The NDIS offer a variety of different accommodation funding options to eligible participants, including short-term accommodation (STA) and medium-term accommodation (MTA). Both types of accommodation can help NDIS participants access temporary accommodation solutions, develop skills, and achieve goals in a safe and supportive environment. Get to know more about STA and MTA, and if it’s right for you. Short-term accommodation… Let’s break it down! Short Term Accommodation (STA) is a claimable support that can be used when you need to be away from your place of residence for a short amount of time. It’s typically for up to 28 days and is suitable for people who need temporary accommodation due to changes in their support needs or for respite purposes. This funding can be used flexibly to suit you and your carers needs. That may be one weekend a month, one week every 3 months or even the whole 28 days. If you have STA included in your NDIS plan, your funding can be used to cover the cost of accommodation and personal care during the stay. However, it’s important to note that STA is not a holiday. STA may be required for a variety of reasons, such as when a your primary carer requires a break, or when you need a temporary alternative living arrangement. Eligibility for STA can vary based on your specific disability-related needs and circumstances. The ins & outs of medium-term accommodation Medium-term accommodation (or MTA) originally launched at the end of 2019. Although not intentional, the timing of the MTA launch was perfect as it assisted NDIS participants during the COVID-19 pandemic who needed accommodation solutions. MTA is generally only funded when: There is evidence of a long-term home You are no longer able to stay in your current accommodation and can’t move into a long-term home yet MTA is typically used as a bridging accommodation during home modifications or following discharge from hospital before moving into Specialist Disability Accommodation (SDA). Eligible NDIS participants may be able to access up to 90 days of MTA, with funding covering the cost of accommodation during the stay. Medium-term accommodation can be provided in a range of settings, including supported independent living arrangements, group homes, and residential care facilities. How to request STA & MTA funding in your NDIS Plan If STA or respite isn’t stated in your plan and you have available funding in your Core budget, you can use that funding for a range of supports including STA where it meets the NDIA’s reasonable and necessary criteria. Currently, this is the same for MTA. However, under the upcoming PACE changes, MTA will no longer be part of your flexible core budget and will only be accessible if MTA is specifically listed in your NDIS plan. If you know that you will specifically need funding for STA or MTA included in your plan, it’s a good idea to discuss your needs with Local Area Coordinator (LAC) or NDIS planner during your first plan meeting or your plan reassessment. This can help prevent you from overspending on your core support budget, which may need to be used for other supports and services. What kind of evidence do I need? To have funding for STA or MTA included in your plan, you may need to provide evidence that: The accommodation is reasonable and necessary for your disability support needs You have a plan in place for your accommodation, including the purpose and duration of the stay The cost of the accommodation is reasonable and comparable to other options Any previous use of STA or MTA and the outcome Any relevant medical reports or assessments to support the need for STA or MTA Any risks if STA or MTA is not provided, including any impact on your health and wellbeing Any personal circumstances that may impact your ability to access other accommodation options It’s important to note that if your circumstances have changed and you need temporary accommodation assistance, you should contact your support coordinator, LAC, or NDIA planner as soon as possible to discuss next steps. What next? If you are approved for STA or MTA, your plan manager or support coordinator can assist you in accessing this funding and finding suitable accommodation options. It's important to note that while the NDIS provides funding for short-term and medium-term accommodation, it's not a permanent solution. The funding is designed to provide temporary support and to assist you in transitioning to longer-term living arrangements that meet your needs. Read more about the benefits of working with an independent, professional Plan Manager. Alternatively, contact our friendly team on 1300 322 273 or support@first2care.com.au.

The NDIS brought about a significant overhaul of disability services in Australia with a focus on ensuring people with disability get the support they need when they need it. Since its introduction in 2013, the NDIS has gone through some minor and major changes which aimed to increase transparency, accountability, and improve access to services. However, after ten years in action there is a call for a NDIS reboot to create a more streamlined approach and enhance the NDIS framework further. Understanding the reboot NDIS Minister Bill Shorten recently stated, 'To enable the NDIS to reach its potential, we need to – in essence – reboot.' And that is exactly what is set to happen… a full NDIS reboot. Following his address to the National Press Club in April of this year, in which he announced details about the reboot, it’s clear the Australian Government have a massive, but necessary, task ahead if they hope to make the NDIS a “more responsive, supportive, sustainable market and workforce.”. The 2023 NDIS reboot is set to unleash a series of reform measures aimed at improving the quality of services and support provided to people with disabilities, reducing bureaucratic red tape (yes please!), and making it easier for people to access the NDIS. A panel of experts including Bruce Bonyhady and Lisa Paul conducted an independent review last October, to address the design, operations, and sustainability of the Scheme, which appears to have informed the direction the reboot is set to take. Policy Directions There are six policy directions that have been addressed, which include: #1 NDIS workforce Focuses on improving the participant experience with the NDIA, through lifting staff caps, returning some call centre functions in-house, and building a balanced staff culture with the intent of reducing staff turnover. There is also a push for greater capability and specialisation needed to proactively intervene to fill service gaps in rural areas and with indigenous communities. #2 Long term planning Focuses on ensuring that better systems are in place for participants with disabilities to prevent participants from having to constantly prove their disability. For example, asking a person with a missing limb to repeatedly prove their limb is still missing or a blind person needing to prove they are still blind, is unnecessary and a waste of resources and time. Instead, the proposal is to have longer term plans that can be adapted to suit participants circumstances throughout their lives. #3 Spiralling expenses Minister Bill Shorten has commented in the past that the prices set by some providers are like a wedding tax – everything is two or three times the cost it should be. Currently there isn’t a system set in place for managing the spiralling of expenses. However, Minister Shorten mentioned potentially trialling “blended payments to improve incentives to achieve outcomes rather than be dependent on more supports.” #4 Better outcomes from SIL Supported Independent Living (SIL) was designed to allow people with higher needs to live in their home with assistance. However, the reality of SIL is that often families and couples are split up and it “drives people into institutional settings that are in some circumstances inappropriate and not in their best interests – in terms of safety, quality and outcomes.” The reform aims to address this and find better home and living decisions for participants. #5 Eliminate unethical practices Unsurprisingly, the push to tackle criminal practices, fraud and unethical behaviour has been addressed as a key focus point for the reboot. The recent crackdown against fraud which currently has 38 investigations underway, involving more than $300m in payments, indicates the Minister for the NDIS means business. The fraud taskforce will continue, in addition to more NDIA staff with the skills to ensure providers deliver outcomes and don’t over-charge. #6 Increasing community and mainstream supports Focuses on ensuring existing mainstream services and facilities, like health, education, and transport are more accessible and supportive for people with disability. As well as boosting investment in community-based programs like sports, recreation activities and education programs. Following Minister Shorten’s speech to the National Press Club, PWDA President Nicole Lee said, “whatever changes are made to the NDIS, these must first and foremost come from a position of the principles of choice and control of people with disability which was one of the main intentions of the NDSI from the beginning.” What would the reboot mean for providers? The reboot is set to usher in a streamlined and simplified system that’s more accessible and responsive to the needs of participants. With the proposed investment boost in community and recreation activities, providers may see an increase in demand for disability support services. While a boost in demand is positive for providers, it may also lead to greater competition among providers working within the sector. Although participants having longer plans isn’t necessarily new (this was introduced during the pandemic), a longer plan for providers does mean less interruptions to service delivery, less administrative time in renegotiating service agreements as new funding packages come in, and more predictability. An important point that has been noted is around the growing scrutiny on overservicing and overcharging participants. The Australian Government and NDIA appear to be in alignment around this issue so it’s worth considering if, as a provider, you are charging people with disability more for your services. If you are, and the NDIA were to question the price, how would you respond? Overall, the 2023 NDIS reboot could be both a challenge and an opportunity for providers, requiring them to invest heavily in their systems, processes, and staff to remain competitive in the market and deliver high-quality services to participants. What would the reboot mean for participants? These reforms offer the potential for significant improvements in services, access, and outcomes for people with disability. However, with any significant reform, there is always a risk of disruption, and the NDIA needs to ensure that there is a clear plan for rolling out these reforms. If the focus remains on ensuring participants maintain choice and control, access to affordable supports and services, and a greater collaboration between the NDIS, disability service providers, and the general community, then the reboot as proposed could be a move in the right direction. Will there be a drop in NDIS funding? The aim of the NDIS is to provide individualised and flexible support to people with disability, and a reboot may be necessary to ensure that this objective is achieved. So, it doesn’t necessarily mean participants will receive less funding. Only the implementation of the reboot will be able to definitively answer that question. However, any changes to funding must be based on thorough assessments, consultations, and an understanding of the participant's needs, goals, and aspirations. It’s crucial that participants are involved in the review process and provided with clear and concise information about any changes to their funding. With any luck, the reboot could actually present more opportunities for participants to access new services, supports, and innovative technologies that can enhance their quality of life and independence. Read more about the benefits of working with an independent, professional Plan Manager. Alternatively, contact our friendly team on 1300 322 273 or support@first2care.com.au.

Unpacking the ins and outs of provider travel under the NDIS can sometimes be a little confusing. Which is why, we've done the work for you. Get to know more about provider travel and the NDIS, claiming eligibility and our top tips for claiming provider travel. Provider Travel & the NDIS As a provider you may be able to claim provider travel (also known as worker travel time) under the NDIS. Like everything with the NDIS, being able to claim worker travel time has specific rules and regulations that need to be adhered to. Typically, providers can claim travel when delivering the following supports: Personal care Community access Therapeutic supports Early Childhood Early Intervention (ECEI) supports Other factors that help to determine if a provider can claim travel include: Type of support being delivered Appointment location Starting location and end location of a provider’s travel journey Check out the NDIS Pricing Arrangements and Price Limits (page 19) for more details on the rules and regulations associated with worker travel claiming. Top Tips for Claiming Provider Travel Tip #1: Set Up a Service Agreement If you’re a NDIS registered provider, you must have a service agreement in place with each participant you provide a service too. Although service agreements are not mandatory for unregistered providers, it is strongly recommended to have one in place, especially if you’re expecting to claim travel. Providers cannot claim travel without first having discussed this with their participant. This should be done prior to commencing your services or in your initial meeting. To ensure clarity of service and expectations from yourself and the participant, it’s a good idea to have a service agreement in place that outlines any costs associated with your services including travel. In the service agreement you will need to specify how and when you will claim travel. One of the most common delays with invoice processing can come from participant confusion around travel charges in their invoices. By setting up a clear service agreement and having a discussion with the participant focused on outlining potential travel costs for your services, you can avoid potential payment delays. Tip #2: Understand the difference between provider travel and participant travel If you are travelling to or from a participant this is considered provider travel which is billable travel time at the same rate as the service which you are providing. If you are transporting a participant as part of the support, this is considered Activity Based Transport. This support is charged differently to provider travel and is billed per kilometre up to $0.97/kilometre (see page 24-26 of the Pricing Arrangements for more details). Not understanding the differences between provider travel and participant travel, could lead to invoice errors which can mean delays in invoice processing. Tip #3: Labour Cost vs. Non-Labour Cost Labour costs (time) is where a provider claims for travel time. The maximum amount of travel time that can be claimed for the time spent travelling to each participant is dependent on the zone. Zone 1-3: 30 minutes Zone 4-5: 60 minutes Zone 6-7 (remote and very remote areas): as agreed up to the hourly rate for the support item In addition, you can also claim for the time spent travelling from the last participant to their usual place of work. Note, this travel is only claimable when the return travel must be paid by the provider’s company. When claiming for travel, you should use the same hourly rate that they have agreed upon with the participant for the primary support (or a lower hourly rate for the travel if that is what they have agreed with the participant) in calculating the claimable travel cost. Non-labour costs are other costs incurred in addition to the cost of the workers time and travel time. This includes: Parking fees Road tolls Costs of running the vehicle Claims can only be made for the non-labour costs associated with provider travel in respect of a support where the rules governing provider travel allow a claim for provider travel time to be made. Claims for the non-labour costs must be made separately to the claim for the primary support and for the travel time associated with the provider travel. Tip #4: Invoice Structure To claim for worker travel time, you will need to create a separate line item on your invoice. The invoice should outline: Support item Provider travel – labour costs (time) Provider travel – non-labour costs (kilometre costs, parking fees and tolls) Rate for each line item (see example below) *To determine the travel cost you will need to review travel zones, pricing and maximum claim time laid out by the NDIS in the NDIS Pricing Arrangements and Price Limits. Tip #5: Keep records It’s important to keep records when claiming worker travel time, not only for yourself and the participant but also in case the NDIA performs an audit of your services. Audits can happen at any time, so it is better to be prepared if the NDIA come knocking. If you have any questions, you can contact our friendly team on 1300 322 273 or support@first2care.com.au.

One of the most common questions we receive from participants is “what is this charge for? I haven’t had an appointment this week.” This question is especially common when it comes to non-face-to-face supports. Although in many cases a support has been provided, when a participant questions why a charge has been made, it can delay the invoice being processed. Understanding Non-Face-to-Face Supports Non-face-to-face supports refer to services that are provided remotely, through video calls, phone calls, messaging, emails, and online platforms. Over the past few years, these supports have become more frequently utilised by NDIS providers to deliver timely and cost-effective services to NDIS participants despite not being physically present. Non-face-to-face supports can include: Report-writing Guidance and advice Assessments Planning and coordination of services Non-face-to-face supports should not include: Processing NDIS claims Training and supervising staff Service agreement negotiation These services can save NDIS providers time and resources while still maintaining quality service for their participants. Great as this option is, the NDIS do have requirements for providers to be able to deliver this type of support, which includes: When the support is included in the participant’s NDIS plan: NDIS providers can only bill for non-face-to-face supports that have been approved and funded by the NDIS. When the support is delivered within the participant’s plan budget: NDIS providers should ensure that the cost of non-face-to-face supports is within the approved budget for the participant's NDIS plan. When the support is delivered within the rules and guidelines of the NDIS: NDIS providers should comply with the NDIS rules and guidelines on billing and claiming for non-face-to-face supports. What are the benefits of non-face-to-face supports? Non-face-to-face supports offer: Increased accessibility: by offering non-face-to-face supports providers can reach more participants across Australia. Flexibility: With non-face-to-face support options, providers can deliver services at a time that is convenient for them, rather than needing to schedule an in-person appointment during business hours. Reduced costs: Without the need for physical premises or travel, non-face-to-face support services can be more cost-effective for providers to deliver. Improved outcomes: Regular and ongoing non-face-to-face communication and support can help to improve participant outcomes by providing ongoing monitoring and support. Personalisation: With the use of various technologies, non-face-to-face support services can be personalised to meet specific needs. Overall, non-face-to-face support is an essential component of delivering supports and services to participants as it allows providers to deliver quality services, overcome distance barriers, and provide personalised and accessible supports to participants. Using non-face-to-face supports If you would like to include non-face-to-face supports in the services you provide participants, it’s important to: Clearly outline in your service agreement whether non-face-to-face supports are going to be claimed, or how it might be claimed. Your client is much less likely to delay payment to query a charge if they are expecting it. Clearly state on the invoice, or relevant line item, when a claim is for non-face-to-face supports Be careful about what activities are being claimed. For example: writing an NDIA-required report is a common non-face-to-face service and is fine to bill to a participants. However, time spent training a junior staff member to write the report would not be considered a suitable claim. How to bill for non-face-to-face supports To help reduce delays, it’s important to consider the following when invoicing for non-face-to-face supports: Determine which non-face-to-face supports are eligible for reimbursement under the NDIS, such as phone or video conferencing, email, and online resources Keep accurate records of the time spent providing the non-face-to-face supports to the NDIS participant Ensure your invoice clearly itemises any non face to face supports Ensure that the invoice complies with the NDIS Pricing Arrangements and Price Limits, which sets the maximum rates that can be charged for different types of supports For more specific guidance on understanding and billing for non-face-to-face supports, you can consult with the NDIA or one of our support team on 1300 322 273 or via email at accounts@first2care.com.au.

Are you concerned about potential funding reductions due to underspending? You’re not alone. Many NDIS participants find themselves underspending their allocated funds during each plan period for various reasons. This guide will help you understand why you might be underspending, what the NDIS will do in response, and how to use your funding more effectively. Why might you be underspending? Occasionally, underspending on your NDIS plan is unavoidable. If you find you are underspending, it’s essential to identify the reasons behind it. Common reasons include: Uncertainty about utilising your funding Saving funds for emergencies Changed circumstances that reduce the need for funding Difficulty finding service providers or facing location-based limitations Illness preventing therapy completion Unavailability of high-cost AT items for which you were funded Support provided by family members Will the NDIS reduce your funding if I don’t use it all? Approaching the end of your plan with underspent funds doesn't necessarily mean the NDIS will reduce your funding for the next plan. The NDIA should carefully consider each new plan, reviewing the provided evidence, and base your funding on your reasonable and necessary needs rather than the amount spent in your previous plan. If the NDIA reduces your funding because you have not fully utilised your previous funds, you can request a review. Be sure to provide as much evidence as possible, sharing any reasons why you couldn't use your allocated funding. How can you use your funding more effectively? To maximise your funding and avoid underspending, consider these tips: Tip #1: Break down your funding Your NDIS plan funding should cover the costs of supports and services throughout the plan period. Allocate a portion of each budget category to the required supports and services to prevent overspending or underspending. Divide the funding according to your preferences, either by month, fortnight, or week. For example: If your Core Supports funding is $18,000 for a 12-month (52-week) plan and you want to know your weekly spending limit, divide the total by the number of weeks. 18,000 ÷ 52 = $346.15 per week. If your supports cost $57.10 per hour, you can access 6 hours of support per week. Don't worry if the calculations seem overwhelming! Our First2Care support team is here to help you break down your budgets and track your funding. Tip #2: Monitor your spending Even with a plan manager handling financial and administrative tasks related to your plan funding, it's beneficial to keep track of your spending and budgets. Our First2Care portal provides real-time budget updates and monthly budget reports. Log in anytime for your funding updates. Tip #3: Plan for high-cost AT purchases Expensive items, like high-cost AT and home modifications, may take time to process and purchase. If you have funding for these items, give yourself enough time to compile reports, obtain quotes, schedule installation, or wait for delivery. What else can you do? When in doubt, contact our support team to talk through your plan options. We’re here to provide support and guidance on using your plan funding effectively. Remember, if you have underspent on your plan funding, discuss the reasons why this occurred with your LAC or NDIA planner during your plan reassessments. Learn more about the benefits of working with an independent, professional Plan Manager. Alternatively, reach out to our friendly team at 1300 322 273 or support@first2care.com.au.

Negotiating better rates with NDIS providers can be a challenging task for participants. However, by understanding the Pricing Arrangements and Price Limits, how provider prices are currently set, and tips for negotiating prices you could succeed in achieving better rates and value for money. Whether you’re looking for a new provider or renegotiating your current agreements, this article can help you achieve a better outcome for your NDIS plan. What’s going on with provider rates & the government? In a recent statement, NDIS Minister Bill Shorten, has criticised the high rates charged by NDIS providers. According to Shorten, some providers are charging exorbitant prices, which are making it difficult for people with disability to access essential services. “If one provider is over-charging for their service, it means a participant cannot afford another service they might need. Participants should be treated as valued clients, not as an ‘ATM’”. He argued that the NDIS was never intended to be a profit-making scheme for providers, and it’s time to address the issue of high fees, which he likened to a “wedding tax” with prices sometimes doubling or tripling. Shorten also highlighted that the government should intervene and ensure that people with disability have access to affordable and high-quality care. While his comments on change and better regulation around provider rates are all well and good, what can be done in the meantime to ensure a fair rate? Understanding the Pricing Arrangements and Price Limits The NDIS Pricing Arrangements and Price Limits has been designed to make it easier for participants to better understand the rates charged by NDIS service providers. Through the pricing arrangements, participants can better evaluate the services they receive and the rates at which they are being charged. This this transparency also allows participants to make informed choices about which service providers to work with and create a competitive market for services. Although the pricing arrangements lists the maximum rate a provider can charge for their supports and services (not the set price), many providers will charge the maximum rate. This doesn’t necessarily mean they are trying to rip you off. There may be several reasons a provider is charging that higher rate, including: Being able to pay their staff, rent, utilities, insurance and other operating expenses Ensuring they can provide high-quality services (i.e., they may need ongoing professional development and training to stay up to date with the latest research and practices) Investing in specialised equipment or tools to deliver their services effectively Their level of skill and experience in the industry When discussing rates and negotiating the best price, take the time to understand the cost factor on their end to ensure you can both come to a reasonable agreement. Negotiate Better Rates With the increasing competition among the number of providers in the industry, some providers are lowering their prices to attract more clients. In these circumstances, it means that participants can secure affordable services that meet their needs without having to pay high prices… but what about the providers who are still charging the maximum price? Although it shouldn’t necessarily be up to the participant to ensure they have a fair rate, negotiating with your providers can help you to make the most of your NDIS plan funding and use it how it is intended. To help you on your negotiating journey, here are our top five tips: #1 Research and prepare Before negotiating with NDIS providers, it’s important to research their pricing structure and familiarise yourself with the industry standards. Have a look at the NDIS Pricing Arrangements and Price Limits to better understand the maximum rate that can be charged then compare that to provider’s you are considering to better understand how competitive their rates are. If there is a provider you really want to work with who is charging more than other providers for the same service, you could use this information to negotiate a lower price. #2 Be clear on your needs Clearly communicate your needs and expectations with the NDIS provider before starting negotiations. Make sure you understand which services are covered by your NDIS plan and which require additional funding. #3 Take your time Don’t rush the negotiation process. Take your time to understand the provider’s pricing structure and consider any alternatives they may offer. This way, you can get the best possible deal. #4 Be flexible While negotiating, be open to compromise and alternative solutions. For example, you may be able to negotiate a lower price if you agree to a longer-term contract or a reduced frequency of services. #5 Know your worth Understand the value you bring to the provider and use this to negotiate a fair price. With more and more providers popping up every day, the industry is becoming increasingly competitive. It’s important to remember that a provider’s goal is to provide quality support. By negotiating better rates, families and individuals can access the services they need and maximise their NDIS funding. Read more about the benefits of working with an independent, professional Plan Manager. Alternatively, contact our friendly team on 1300 322 273 or support@first2care.com.au.

There are a number of different pathways you can take to achieve your employment goals, and the good news is… the NDIS can help! Having a job or even a small business can help you to expand your social network, increase your financial independence and build you capacity and confidence. Find out how you can get started on your employment goals today. NDIS Capacity Building Supports: Finding and Keeping a Job If you’ve been thinking about entering the workforce or need assistance to maintain your current employment, the NDIS can help through your capacity building supports. The main support category for employment is called ‘Finding and Keeping a Job’ which supports people with disability to get into the workforce, build independence and maintain their employment. There are other categories that can help you with your employment goals, like ‘Increased Social and Community Participation’ which can assist you in developing the skills needed to enter the workforce. To access funding for ‘Finding & Keeping a Job’, you should discuss your employment plans with your NDIA planner or LAC during your planning meeting or plan reassessment. They may ask you the following types of questions: What are your employment goals? Do you have any specific skills, qualification, or work experience? What level of education do you have, or have you completed any courses in the field you would like to work? Do you manage your own finances? Do you need assistance in a workplace environment*? *If you need a support worker to be with you in the workplace due to the impact of your disability, it’s important to discuss this with your NDIA planner, LAC or Support Coordinator as funding may be available to help you engage a support worker. Top tip: the NDIA have a booklet you can use called ‘Let’s talk about work’ that can help you prepare the necessary information to present to your NDIA planner or LAC during your planning meeting or plan reassessment. School Leaver Employment Services (SLES) If you’re a school leaver you may be eligible to access School Leaver Employment Services (SLES). This support is available to students in their final year of secondary school for up to two years. SLES is designed to help you develop your skills and confidence to transition smoothly from school into the workplace. SLES can support you to: Build your motivation and confidence joining the workforce Develop key capacity building skills for the workforce and within the community Help you to determine your career aspirations and goals Gain a nationally recognised qualification If this is a path you’d like to take as a school leaver, you’ll need to engage an SLES provider. There are plenty or providers to choose from who can get you work ready. Try to find a SLES provider that suits your individual employment goals so you can make the most of their services. Starting your own small business Have you ever dreamed of starting your own business? There are currently two types of NDIS funding that may be relevant to you – Employment Supports & Supports in Employment (Specialised Supported Employment). Employment Support can help you to build your capacity by providing you with short-term assistance. It can help you to better understand the types of work that you are interested in, develop your skills, manage complex barriers, or develop a career plan. Supports in Employment (Specialised Supported Employment) provides tailored support for NDIS participants who are less independent, need help to manage behaviour, or need ongoing support in the workplace. This means there is ongoing core budget funding that can be used in any place of work including self-employment, a micro-business, or a family run business. It may include: On the job training Intermittent support with daily work tasks Personal care Assistance with managing behaviour or complex needs If you’re not ready to make the leap into starting your own business, you can explore platforms like Enabled.vip that encourage disability entrepreneurships. It can be a great option to help you better understand how to start your small business. How we can help First2Care is growing, which means our team is growing too. As new roles become available, we encourage people from within our community who have a passion for helping others, understanding the ins and outs of the NDIS and want to join a great team to apply through our Enable HR portal. If you have any questions or want to know if there are any roles available, reach out to our support team on 1300 322 273 or email hr@first2care.com.au for more information. Read more about the benefits of working with an independent, professional Plan Manager. Alternatively, contact our friendly team on 1300 322 273 or support@first2care.com.au.

Think of the Pricing Arrangements and Price Limits as your go-to guide for navigating the pricing rules and regulations set out by the NDIA. Every provider should aim to be in the know when it comes to pricing limits, line items, and any key changes that might be made. With updates being released each financial year (sometimes with minor updates throughout the year), there’s no better time than right now to understand the ins and outs of the Pricing Arrangements and how to use it effectively. Using the Pricing Arrangements The Pricing Arrangements and Price Limits has a list of over 2,500 items and services that can be funded by the NDIS. These items and services have a price limit (the maximum amount that can be charged) which is updated on a yearly basis. With so many items and services listed in the Pricing Arrangements, sometimes it can be confusing trying to figure out which line item you should use when invoicing a client for your services. To make things easier, the Pricing Arrangements is broken down into categories. They are: Core: help with everyday activities and community access. Capital: fund Assistive Technology (AT) and/or Home Modifications. Capacity Building: help to build skills and independence in daily life, and help you pursue your goals. Plan Management support is allocated under this support category under Improved Life Choices. The Core, Capital and Capacity Building Supports have subcategories that can help you better understand where your supports and services are categorised. For each service listed in the Pricing Arrangements, there is a corresponding line item. For example: Top tip: remember to check for pricing limit differences corresponding to the time of day, night supports and public holidays. Pricing Limits & Setting your Rate Other than outlining the maximum amount that can be charged for supports and services, the Pricing Arrangements also shows: Current and previous price limits for each support item Claim types including travel and non-face-to-face supports Price limits for different times of day It’s important to use the Pricing Arrangements as a guide to help you make informed decisions when it comes to pricing your services. Some questions you may want to consider after reviewing the Pricing Arrangements and before setting your price are: What is your current experience level? What price would be considered fair and provide value for money for each service provided? Is there a pricing difference based on whether the support is in person or not in person? Have you discussed pricing with the NDIS participant you are supporting? Does there need to be an adjustment in the pricing that has been set? For more information on setting your rate, check out our blog ‘Understanding & Making Pricing Decisions’. Top tip: when setting your pricing, talk with your client to help them understand the decision making behind the price and involve them in the discussion. What to do if your support fits into more than one line item Sometimes you may find that your supports and services could fit into multiple line items. In this circumstance, pick the most relevant line item that aligns with your client’s Plan. For example: Exercise physiology appears in two Capacity Building budgets: 12 – Improved Health and Wellbeing 15 – Improved Daily Living Using a support item code that is not included within the participant’s plan can cause slight delays if we need to confirm some details. For example, one of the budgets might be NDIA-managed, and should not be paid with plan managed funds. How the Pricing Arrangements can help speed up your invoice processing We receive lots of invoices every day, and each invoice is a little different. However, they should have some key elements* to help us to process them quickly. One of those key elements is including a line item. Although our team may be able to determine what line item your support corresponds to, by including it in the invoice it saves us time searching for the right line item, and our team can process invoices much faster. *For a full checklist of everything you should include in your invoices, check out our downloadable Provider Invoicing Checklist. If you have a participant who is plan managed with First2Care, you can register your details with our First2Care team for quick and easy payment processing. Read more about First2Care Plan Management here.

Despite changing the name from ‘Price Guide’ to ‘Pricing Arrangements and Price Limits’ in 2022, there is still some contention as to who sets the rate a provider will charge a participant for a support or service. So, who really makes the prices and do participants have a say in what they are charged? Who decides the price for supports and services? Although the NDIA set a price limit (essentially the maximum price a provider can charge for a service), they don’t set the actual price a participant will pay. This is up to the provider and the participant. Typically providers will decide their own prices based on the cost of delivering supports and services. They cannot charge you more than the limit set by the NDIA but often providers will charge whatever the limit is. For example: The maximum rate for 01_011_0107_1_1 Assistance with self-care activity is $62.17 per hour. Which means, a provider could charge anything up to $62.17. Top tip: larger provider businesses typically charge the maximum rate because they have additional costs that need to be covered (i.e., admin costs). For some participants, it might be beneficial to consider a smaller provider. What are the Pricing Arrangements & Price Limits? The Pricing Arrangements and Price Limits are designed to let providers know the maximum price they can charge for their services. They can also help participants better understand and manage their budgets. The NDIS Pricing Arrangements and Price Limits document is broken up into three parts: Support purpose Support categories Line items Support Purpose & Support Categories There are three support categories (or purposes) that make up and NDIS plan – Core Capital, and Capacity Building. Core Supports: help with everyday activities and community access. Capital Supports: fund Assistive Technology (AT) and/or Home Modifications. Capacity Building Supports: help to build skills and independence in daily life, and help you pursue your goals. Plan Management support is allocated under this support category under Improved Life Choices. There are a total of 15 support categories. Support Items (also known as line items) Line items are codes that help to identify which funding category supports will be paid from. Each support item has a unique reference number based on the below structure: Support Category > Sequence number > Registration Group > Outcome Domain > Support Purpose For example: Top tip: A provider should never indicate to a participant that the price they set is decided by the NDIA. The Pricing Arrangements and Price Limits only shows the maximum rate. Why it’s important to understand the Pricing Arrangements & Price Limits As a participant, you can negotiate the rate with your service provider. This is best done when you are initially engaging their services and creating a service agreement with your provider. When you know what the maximum price a provider can charge is, you will be better equipped to gauge what that support or service is actually worth. You can do this by shopping around. Find out what other providers are charging for the same supports and services and use this as evidence to negotiate a better rate. If you feel like a provider, registered or unregistered is charging an unreasonable amount for their services, a disability advocate, or your support coordinator (if you have one) can help on your behalf. Having a NDIS plan doesn’t mean you should be charged more. You have a right to a fair rate. Top tip: when searching for a provider, consider what their qualifications are and the price they are charging for their services and compare them to ensure you are getting the support you need for a good price. How we can help When our accounts team receive an invoice, we check the price against the NDIS Pricing Arrangements and Price Limits to ensure that providers are claiming within the limits. If you need help to better understand the Pricing Limits and Price Arrangements, you can contact our team or speak with your support coordinator or LAC. Read more about the benefits of working with an independent, professional Plan Manager. Alternatively, contact our friendly team on 1300 322 273 or support@first2care.com.au.