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The Federal Government announced new legislation which aims to protect participants and ensure they receive high-quality support by strengthening the powers of the NDIS Quality and Safeguards Commission. This is part of the "Getting it Back on Track Bill." One of the major changes is a significant increase in penalties for NDIS providers when participants are harmed under their care. Currently, providers face fines up to $400,000, but under the new law, this could rise to over $15 million. The proposed law will also allow, for the first time, the possibility of criminal prosecution for providers who seriously neglect their responsibilities. Key updates in this legislation include: Stronger Penalties and Criminal Offences: The law will introduce tougher penalties and new criminal charges for providers who fail to meet the required standards, discouraging unsafe practices. Enhanced Monitoring: The Commission will have better tools for gathering information to closely monitor and ensure providers comply with NDIS standards. Broader Banning Powers: Banning powers will be extended to cover not just providers but also people working in other roles within the NDIS, such as consultants and auditors. These changes are in response to recommendations from both the Independent NDIS Review and the Disability Royal Commission. The government is actively seeking feedback from the community, with consultations currently taking place through November and December 2024. Through this ongoing engagement, the Australian Government hopes to shape reforms that truly benefits participants. The legislative update is part of a broader effort by the Albanese Government to protect the rights and wellbeing of people with disabilities. For more information, refer to the NDIS Provider compliance link here

With the recent changes to the NDIS taking effect from the 3rd of October, the guidelines on what is and isn't covered have become more clearly defined. While this updated list provides structure, the NDIA recognises that flexibility is important. This is where "Replacement Supports" come into play. These are items or services that can replace existing supports within a participant’s plan, provided they meet specific criteria. What Is Replacement Supports? Replacement supports allow participants to substitute an existing NDIS-funded support with a different item or service that meets their needs equally or better, without adding to the cost. These are not additional supports, but replacements intended to promote independence and reduce the reliance on more expensive or labour-intensive options. Criteria for Replacement Supports For providers working with NDIS participants, it's essential to understand the criteria that make replacement supports viable: The replacement must be a direct substitute for an existing support in the participant’s plan. It must offer the same or improved level of assistance. The cost of the replacement must be the same or lower than the support it’s replacing. The replacement support should help the participant manage their disability needs more efficiently while keeping within the plan's budget. How Providers Can Support Participants with Replacement Supports As a provider, you play a crucial role in guiding participants through the process of choosing replacement supports. These items should enhance independence, reduce the need for ongoing support, and fit seamlessly within the existing budget. Example. Apps for Accessibility or Communication Why It May Be Allowed: Apps that help participants access information, manage schedules, or assist with memory and communication can reduce their need for personal assistance. For example, a text-to-speech app might allow a participant with vision impairment to access written material, reducing their dependence on support workers for this specific task. What Providers Should Consider When discussing replacement supports with your Participants or their representatives, it’s important to ensure that these items: Are genuinely beneficial and improve the participant’s ability to manage their disability. Do not require a higher budget than the current supports being replaced. Are a good fit for the participant’s long-term goals for independence. Next Steps for Providers If your Participants are considering replacement supports, it’s vital to help them navigate the process with the NDIA. Ensure that the replacement fits their plan and provide guidance on whether the support will enhance their daily life without exceeding budgetary constraints. For Replacement Supports to be approved, the following form must be submitted to the NDIS, Application for replacement support. Collaborating with support coordinators and the NDIA, you can help participants make informed decisions about replacement supports that will best meet their individual needs. Keep in mind that these replacements are not additional funding but are meant to be cost-effective substitutes that foster greater independence. For more details or to assist your clients in exploring replacement supports, feel free to reach out to our team or the NDIA for guidance.

With the recent changes to the NDIS now into effect, starting 3rd of October, the list of what is and isn't covered under the NDIS is now more clearly defined. While the list is defined, the NDIA recognises that it's not a one size fits all, so they have created a list of items called 'Replacement Supports' that can be put in place as long as they meet certain considerations laid out by the Agency. What is Replacement Supports? Replacement supports are items or services that a participant can use instead of an existing NDIS support in their plan. They are not additional supports but replacements that must meet certain criteria. These replacements are allowed when they provide similar or greater benefits to the participant and do not increase the overall costs. A replacement support can be considered if: It replaces an existing NDIS support in your plan. It offers the same or better level of assistance as the support being replaced. It costs the same or less than the support it’s replacing. The key requirement is that the replacement item addresses your disability needs without increasing your NDIS budget. Replacement Supports and Why They Might Be Approved The NDIS defines replacement supports as items or devices that help participants perform daily tasks independently, reducing the need for ongoing assistance. These supports are often essential for increasing a participant's independence by enabling them to complete tasks without the help of a support worker or other support. They are typically approved when they replace the need for more costly or labour-intensive options, supporting participants' ability to manage their routines and communication more effectively. The key consideration is that these supports enhance independence and reduce the need for continued external support. Example. Apps for Accessibility or Communication Why It May Be Allowed: Some apps provide essential functions for participants with disabilities. For example, a participant with vision impairment might use a text-to-speech app to access written material. Apps that assist with scheduling, memory support, or tracking health conditions can also enhance a participant’s ability to manage their daily life independently, reducing the need for other supports. These supports must be approved based on the criteria and should replace existing supports without increasing the overall budget. Should you seek out a replacement item, consider that you are getting the item in place of a support that you currently receive. This means the NDIS will determine that you will no longer need the support you have chosen to replace. For Replacement Supports to be approved you must submit the following form to the NDIS, Application for replacement support. If you’re considering a replacement support, speak with us, your support coordinator or the NDIA to determine how it might fit into your plan.

On August 22, 2024, the Australian parliament passed legislation that changes the NDIS Act. The NDIS is no stranger to reform, and this amendment heralds the beginning of a new period in NDIS history. One of the most contentious and well-publicised changes is the definition of NDIS Supports, which includes a temporary list of supports and services that are and are not claimable with NDIS funding. The NDIA and the federal government have published several announcements and summaries of the amendments to the Act, and we expect this landscape to shift over time. As far as legislation writing goes, this one has gone through very quickly and what may be true one day may change significantly the next as the government responds to public consultation and negotiations with state and territory governments. NDIS Supports – What you need to know When the law takes effect, starting the 3rd of October, claims can only be made for supports or services on the published list of NDIS Supports: Draft list of NDIS Support | engage.dss.gov.au These lists are subject to change and require the creation of a permanent rule within the legislative framework. This will be developed in consultation with state and territory governments. In the meantime, a transitional rule will be in place, which is the draft list of NDIS Supports. The effective date is expected to be in mid- to late September 2024. If an invoice is submitted for a support or service that is on the list of things that are not defined as NDIS supports, it will not be processed without explicit authorisation from a Planner. Why have these changes been made? The government has heard from participants that it is often not clear what funding can or cannot be spent on. The purpose of defining a specific list of items that cannot be purchased with NDIS funds is to clarify the existing guidelines. It does not create any new rules. What about “reasonable and necessary” and “choice and control”? The reasonable and necessary criteria remain in place and have not changed. By inserting a definition of ‘NDIS support’, the Bill does not tighten the kinds of supports the NDIS will fund. Instead, the Bill clarifies the supports that have always been available under the NDIS to ensure certainty for participants now and into the future.   Participants have choice and control to direct their funding, as long as it is within the bounds of the Plan, which sits within the bounds of the NDIS guidelines. Read more about the changes on the NDIS website here: Changes to NDIS legislation | NDIS

As NDIS participants, understanding how your funding is allocated and how therapy supports can be claimed is key to making the most of your plan. You may have heard some discussions about whether therapy supports can be invoiced from your core funding, and this can sometimes feel like a bit of a “grey area.” However, recent guidance clarifies this issue, and there are some important updates you should know about. Visualising How Your NDIS Funding Works To help you visualise how your NDIS plan works when it comes to therapies, think of it like this: Improved Daily Living (Category 15): This budget is designed for therapies that promote functional improvement. It’s a more flexible area for therapy supports, including things like Art Therapy, Occupational Therapy, and Psychological support. Core Funding: This is focused on maintenance care and specific disability-related health supports, such as those listed above. The scope is narrower and designed to assist with ongoing health needs directly related to your disability. Core Funding and Therapy Supports When a service provider invoices for therapy supports using core funding, they are legally declaring that the therapy they are providing falls within the NDIS Pricing Arrangements and Price Limits (PAPL). This means the therapy must address specific health-related needs directly linked to your disability. These include: Dysphagia (difficulty swallowing) Respiratory issues Nutrition Diabetes management Continence care Wound and pressure care Podiatry Epilepsy management For example, if you receive therapy that helps with functional improvement in any of these areas, core funding might be used appropriately. But therapies outside these health-related areas, such as Art Therapy, may not fit under core funding. While art therapy could support your overall functional improvement, it’s likely better claimed under the Improved Daily Living budget (category 15), which covers a broader range of therapy services. Changes Coming in 2025-26 From the 2025-26 financial year, certain therapy support items in the NDIS core budget are scheduled for removal. This is important because some participants currently use core funding for therapies. However, before proceeding, you and your service providers need to make sure that claims are compliant with NDIS guidelines. Stay Compliant and Get the Most from Your Plan It’s always a good idea to review your invoices and make sure your service providers are clear on how to bill for therapies. This will ensure that your claims are processed smoothly and that you’re getting the maximum benefit from your plan. If in doubt, ask your provider to explain how they’re invoicing and what category they are using in your plan. By staying informed and working with your providers, you’ll be able to navigate these changes and use your NDIS funding in a way that best supports your needs.

NDIS Minister Bill Shorten recently announced that Platform Providers, Support Coordinators, and Supported Independent Living (SIL) Providers will soon be required to register with the NDIS Quality and Safeguards Commission. This new rule aims to improve service standards and strengthen safeguards for NDIS participants. Why Are These Changes Being Made? These changes are based on recommendations from the NDIS Provider and Workforce Registration Taskforce, which has focused on ensuring that all providers deliver safe, reliable, and high-quality care to participants. Previous inquiries by the NDIS Commission revealed risks associated with unregistered providers in these specific service categories, prompting the need for stricter regulations​. What Do Providers Need to Do? Affected providers will now need to undergo mandatory registration with the NDIS Commission. A transition period will be provided, giving providers ample time to comply with the new rules. The NDIS Commission is also holding consultations starting in October 2024 to guide both providers and participants through this transition​. What's Next? Although the changes are significant, providers don’t need to take immediate action. However, it’s essential to start planning for the transition and stay informed about the developments to ensure compliance with the new regulations​. Read the full recommendations here: Summary of Advice: NDIS Provider and Worker Registration Taskforce | Department of Social Services, Australian Government (dss.gov.au) The Commission also has a news page here: Important information for platform providers, support coordinators, and Supported Independent Living (SIL) providers | NDIS Quality and Safeguards Commission (ndiscommission.gov.au)

We recently published some guidance for providers when invoicing for therapy supports. It is an area that has often been considered a “grey area” or a loophole in NDIS claiming. However, this is not quite the case. In fact, the writing is on the wall for these support items, as the NDIS has slated them for removal from the start of the 2025-26 financial year. While some participants may wish to use their core funding to pay for therapy, it is important to keep your obligations as a service provider in mind. By issuing a tax invoice with one of these support item codes, you are declaring that the service provided complies with the arrangements specified by the Pricing Arrangements and Price Limits (PAPL). This means that you are indicating that you are providing supports to assist participants in one of the following areas: Dysphagia Respiratory Nutrition Diabetes Continence Wound & Pressure Care Podiatry Epilepsy This is why the number of therapy support items in core is not as extensive as the Improved Daily Living Budget. It is unlikely that an Art Therapist is providing support in one of the above areas, for example, but reasonable that their services could facilitate functional improvement. A useful way to visualise it is: Improved Daily Living (15) Core Functional improvement Disability Related Health Supports Maintenance care Disability Related Health Supports Source – Pricing Arrangements 2024-25 Version 1.0, pages 37, 85. We recommend double checking your invoicing systems and working with participants to ensure that claims are compliant and smooth as possible.

There are upcoming changes to the NDIS that you should be aware of. NDIS Minister Bill Shorten has announced that platform providers, Support Coordinators, and Supported Independent Living (SIL) providers will soon need to register with the NDIS Quality and Safeguards Commission. We have written previously about the NDIS Provider Registration Taskforce, established in response to the NDIS Review. Some of these planned changes are the first steps in implementing the Taskforce’s recommendations. Read the full recommendations here: Summary of Advice: NDIS Provider and Worker Registration Taskforce | Department of Social Services, Australian Government (dss.gov.au) Why Is This Happening? These changes come from recommendations made by the NDIS Provider and Workforce Registration Taskforce, which looked at how to improve the NDIS for participants. The goal is to make sure that all providers offer safe, reliable, and high-quality support. The NDIS Quality and Safeguards Commission have previously conducted Own Motion inquiries into Supported Accommodation, Support Coordination and Plan Management, and Platform Providers, based on the risks associated with these supports and services. Of these, Plan Management is already required to be delivered by registered providers. What Does This Mean for You? These changes are focused on ensuring that the providers you rely on meet a standard level of care and accountability. There will be a transition period, which means there will be time for providers to adapt to these new rules, and you should not experience any immediate disruptions to your services. The Commission is planning to begin a consultation process with NDIS participants and providers in October 2024, to explore how providers can be supported to transition from unregistered to registered. However, there is no doubt that there may be significant changes to the provider landscape. If you are using a support coordinator or SIL provider that is not registered, for example, you may wish to discuss this with the provider. The registration process consumes time and resources, and some smaller providers or sole traders may find it daunting. Will More Changes Happen? The government has prioritised this change for provider registration, but they will continue working closely with the disability community, including participants, to decide on any further changes. Importantly, the Government has said that any additional changes will be planned with input from people who use NDIS services. For now, there is no need to worry or make any changes yourself. Your current services will continue as normal, and your providers will have time to adjust to these new requirements. We will keep you updated with any important information as more details become available. If you have any concerns or questions, reach out to your support coordinator or NDIS contact for more information. For more information you can read the official media release from the Ministers office here Stronger registration to begin for NDIS sector | Department of Social Services Ministers (dss.gov.au). The Commission also has a news page here: Important information for platform providers, support coordinators, and Supported Independent Living (SIL) providers | NDIS Quality and Safeguards Commission (ndiscommission.gov.au)

The 2024-25 Pricing Arrangements brought a change to how short notice cancellations are to be claimed. Things are a little more complex now, which is why it’s a good time to dust off service agreement and invoice templates. Queries about cancellation charges contribute to a large proportion of the reasons why an invoice might be delayed or disputed by a participant. Being clear and compliant with NDIS guidelines will lead to a better working relationship with participants and their families. The Rules The NDIS Pricing Arrangements and Price Limits have a suite of requirements that must be met before a claim can be made for a short notice cancellation, and the required notice period varies depending on whether the support is a disability support work or not. For disability support work, providers may claim for 100% of the agreed fee for their service if given less than 7 days’ notice. For non-disability support work, such as therapy appointments, the notice period is 2 clear business days (note the difference between days and business days). For both types, the following also applies: The NDIS Pricing Arrangements and Price Limits document indicates that providers can claim for a Short Notice Cancellation - 7 clear business days, in respect of that support item. This means that some supports are not eligible for cancellation fees, such as Activity-Based Transport. The provider was not able to find alternative billable work for the relevant worker and are required to pay the worker for the time that would have been spent providing the support. A bit trickier to determine, but it makes sense. Cancellation charges allow companies to avoid having to pay staff for work that cannot be funded. However, if the staff that were going to deliver the now-cancelled shifts have been successfully reallocated to other work, claiming the cancellation may be seen as double-dipping. Providers should document the terms of short notice cancellations polices in participant service agreements. This is a simple one. Clearly outlining cancellation terms means that disputes may be less likely to arise. It is important to note that providers cannot impose terms or conditions that are not in line with the Pricing Arrangements.

Focusing on participant-centric service delivery is more than just a trend—it’s a fundamental approach that can lead to better outcomes and higher satisfaction for the people you support. With the recent emphasis on making the NDIS more about participants and less about bureaucracy, highlighted in the latest NDIS Review, it’s essential for providers to implement strategies that prioritise the needs and preferences of participants. Understanding Participant-Centric Service Delivery Participant-centric service delivery is about placing the participant at the core of every decision-making process. This approach ensures that services are tailored to meet the unique needs of each individual, aligning with the NDIS core principles. For providers, this means going beyond a standardised service; it involves actively listening to participants, understanding their goals, tailoring the service delivery by working collaboratively with participants to achieve better outcomes for them. Key Strategies for Implementing Participant-Centric Approaches Personalised Planning and Engagement: Effective service delivery begins with a deep understanding of each participant’s unique circumstances, goals, and preferences. Engage with participants regularly to ensure that the supports being provided remains aligned with their evolving needs and aspirations. Encourage participants to actively participate in the planning process by providing clear, accessible information about their options and helping them navigate complex decisions. This empowers participants to make informed choices that best suit their needs. Flexibility in Service Provision: Flexibility is crucial in meeting the diverse needs of NDIS participants and the impact it may have on their wider support network. Providers should explore ways to offer services that can be adapted to individual circumstances, whether that means adjusting the timing of services, offering a broader range of options, or responding quickly to changing needs. Being flexible also involves accommodating participants' preferred methods of communication, whether through in-person meetings, phone calls, or digital platforms. Ensuring that all participants feel supported and understood is key to effective service delivery. Empowerment Through Information and Choice: Empowering participants to make informed choices is central to participant-centric service delivery. This means providing clear, accurate, and timely information about all available supports and services. Providers should focus on demystifying the complexities of the NDIS, helping participants understand their the more complex details of their plan, the options available to them and within their budget. Facilitating access to this information allows participants to make decisions that are truly in their best interest, promoting autonomy and self-determination. Building Trust and Transparency: Trust is the cornerstone of a successful participant-provider relationship. Providers should prioritise transparency in all interactions, including clear communication about costs, services provided, and any potential changes to the participant's plan. Transparency in service delivery also includes clear reporting and open communication about how funds are being used and where costs have exceeded the initial agreement between the provider and the participant. Participants should feel confident that their funds are being considered. Continuous Improvement and Feedback Integration: A participant-centric approach requires ongoing evaluation and adaptation. Regularly seek feedback from participants and their families to identify areas for improvement. This feedback should be treated as a valuable resource for refining services and enhancing the participant experience. Incorporate participant feedback into your service delivery models by adjusting service offerings, enhancing communication strategies, or improving the accessibility of services. Continuous improvement ensures that your services remain relevant and effective. The Role of Providers in Facilitating Participant-Centric Services As a provider, you have a unique opportunity to advocate for your participants and ensure that their NDIS journey is as smooth and empowering as possible. By adopting a participant-centric approach, you can help participants feel more in control, leading to better outcomes and higher satisfaction for everyone involved. The shift towards participant-centric service delivery is not just about meeting compliance requirements—it’s about fostering a genuine partnership between the provider and the participant. When participants feel heard, valued, and supported, the benefits are clear: improved well-being, greater independence, and a more effective and meaningful use of NDIS resources. In conclusion, participant-centric service delivery is the future of the NDIS. By embedding these principles into your daily operations, you can ensure that your services not only meet the needs of your participants but also empower them to lead the lives they choose.

As an NDIS provider, the primary purpose should be to play a valuable role in a participants support team to help them achieve their goals through the effective use of their NDIS funds. It’s important to strike a balance between offering high-quality services and ensuring that these services are provided at a fair and reasonable price. Here’s some areas to explore, considering the impact on participants funds and delivering value for money services where possible. Focus on Participant-Centric Planning Understand the Participant’s Needs: Begin by thoroughly understanding the participant’s needs and goals. This allows you to recommend services that are necessary, beneficial and focus on outcomes aligned with their goals. We should be avoiding the temptation of over-servicing our support where there could be another part of their plan impacted or funding unknowingly is exhausted before the plans end date. Align Services with Goals: Ensure that the services you provide directly contribute to the participant’s goals. This not only builds trust but also ensures that funds are spent where they are most needed, avoiding unnecessary expenses. Outcomes for participants resulting in ever-evolving goals will show progress for your service and the NDIS. Transparent Pricing Set Fair Prices: It’s crucial to set service prices that reflect the actual cost of delivery without adding excessive margins to reach the maximum limit given in the Pricing Arrangements and Price Limits. Transparent pricing helps build trust and ensures participants feel confident that they are receiving value for money. Avoid Hidden Fees: Clearly communicate any costs associated with your services upfront. Avoid hidden fees or charges that could surprise participants later, as this can erode trust and lead to financial strain on their plan or for them personally. When they see the invoice for approval, there shouldn't be any surprises. Competative Pricing Market-Driven and Choice: Providers compete on price, quality, and service, leading to a dynamic pricing environment. Participants have the power to choose from a variety of providers, which encourages companies to offer competitive prices. This competition drives innovation and efficiency within the Scheme. Free Market with Limits: The NDIS incorporates elements of a free and competitive market while maintaining strong protections for participants. Although service providers compete within the system, limits are placed on services to ensure fairness and prevent overcharging. This approach encourages providers to focus on delivering high-quality services and better outcomes rather than simply competing on price. By blending market competition with limits on pricing, the NDIS ensures that participants have access to affordable, consistent, and high-quality supports. Offer Flexible Service Options Tailor Services to Budget: Provide participants with flexible service options that can be tailored to fit their budget. This may include offering options for various levels of service or the amount of time to be allocated to each support or service. It can also help to provide options for group sessions. Promote Cost-Effective Alternatives: Where appropriate, suggest more affordable alternatives that still meet the participant’s needs. This could involve exploring different service delivery methods, such as virtual consultations, which would normally be less expensive than in-person visits and doesn't include time spent travelling. Regular Budget Reviews Check-in Regularly: Help participants keep track of their spending by offering regular budget reviews. This ensures that they are not overspending on services and that their funds are being used effectively. They may have had some unforeseen circumstances occur around another service, therefor impacting the ability to continue with your level of service for the full plan period. Adjust Services as Needed: Be willing to work with the with participants to adjust their service delivery as they require, services are not always routine and where adjustments can be made, this can sometime make a massive difference to the participants circumstances and lead to more positive outcomes. Build Long-Term Relationships Through Trust Prioritise Ethical Practices: Always act in the participant’s best interest. Avoid the temptation to push services that are not essential or that could strain their budget. Ethical practices not only protect the participant but also enhance your reputation as a provider. Focus on Sustainable Outcomes: Encourage participants to spend their funds in ways that will provide sustainable, long-term benefits. This could involve investing in capacity-building services that help them become more independent over time. Pro-Participant Approach Helping participants manage their NDIS funds effectively requires a commitment to fair pricing, transparency, and a focus on their best interests. By offering tailored services, avoiding unnecessary costs, and maintaining open communication, you can ensure that participants receive the support they need without the burden of overpricing. This approach not only benefits the participant but also builds a foundation of trust and long-term success for your role as a provider.

Leaving the National Disability Insurance Scheme (NDIS) is a significant decision, whether you’ve achieved your goals, are transitioning to aged care, or experience a change in eligibility. Here’s how to navigate the process with confidence. Why Exit the NDIS? People leave the NDIS for various reasons. You might have reached your goals, gained independence, or moved into aged care after 65. In other cases, changes in residency or citizenship, or no longer meeting the disability criteria, might make you ineligible for continued support. The Process of Leaving Submit Your Request in Writing: If you decide to exit, you’ll need to submit a written request to the NDIS. This formal step is crucial—verbal requests won’t suffice. Use the “Leaving the NDIS” form, which can be sent via email, mail, or delivered in person at an NDIS office. Understand the Impact: Exiting means your NDIS plan ends, and any unspent funds become inaccessible. Make sure you have considered all your options and discussed your situation with family, friends and providers. If you later wish to rejoin, you’ll need to reapply and meet the eligibility criteria in place at that time. Plan for the Future: If you’re leaving due to a transition to aged care or a change in eligibility, consider how you’ll continue receiving support, possibly through services provided by the Department of Health. What Happens After You Exit? Once your exit is processed, you’ll receive a formal confirmation that your NDIS plan has ended. This documentation is important for future reference. If circumstances change, rejoining the NDIS is possible but requires meeting all current eligibility criteria. For Families with Young Children Children, particularly those under 7, may exit the NDIS if early intervention has sufficiently improved their capacity. The NDIS will help families connect with other supports if necessary, ensuring a smooth transition. Final Thoughts Exiting the NDIS is a pivotal step that should be approached thoughtfully. Whether you’re moving on because you’ve achieved your goals, transitioning to new types of support, or facing eligibility changes, understanding the process will help you make the best decision. For more details, visit the NDIS Leaving the Scheme page.