Do I have to use a registered provider?
NDIS funding does not currently require the sole use of registered providers unless you are agency managed. If you are agency managed you do have to use registered providers and if you are plan-managed or self-managed then you have the freedom to choose.
Who can I book then?
You can book registered or independent providers. Any credentials or accreditation should be clearly labelled and documented before entering into service Agreement.
You might decide to book all your support services through one service provider, or split funds between your existing providers and new bookings on a different platform.
There are apps available that show you all your options including registered providers and independent contractors. And, some of these apps even do all the paper work (ensuring compliance) as well as offer budgeting tools to help you stay on track.
Ultimately, how you manage your funds is up to you.
Some things to consider
Keep in mind that if you are self-managed, you will have to submit invoices for audit to prove you are spending your funds in-line with your NDIS plan.
You’ll need to provide invoices, receipts or other evidence as proof of how you’ve spent your funds. This becomes very important over time. So, no matter who you choose to go with, whether registered NDIS provider or an independent contractor, be sure to have the right records, including details of the service given, every time.
You can ask for an NDIS Worker Screening check
Under the NDIS, self-managed participants are encouraged to require their workers to have an NDIS Worker Screening. Not all organisations require workers to obtain these checks, and independent contractors are unlikely to have had this specific screening. This is a relatively new development and offers a detailed background check on workers, offering more safeguards and control for participants.
Note that some states and territories are deciding whether or not to enforce mandatory checks for all providers regardless of registration status.
What does a support coordinator do?
To put it simply, NDIS support coordination means that there are people available to help you navigate the NDIS. Their aim is to ensure you understand the NDIS so as to get as much value from the NDIS as possible.
A support coordinator is someone who the government defines as “a capacity building support to implement all supports in a participant’s plan, including informal, mainstream, community and funded supports.”
An NDIS support coordinator is trained to help you understand what services and funds are available to you - to answer your questions and assist in the process.
You can find support coordinators everywhere - not just at the NDIS itself. Most NDIS partner organisations will have someone working in support to help you figure it all out - including planning your goals and the ways you want to achieve them. It’s a relatively new role but an important one, with the latest NDIS Price Guide defining the role below:
- Connection: assisting participants to develop knowledge, experience and connections with the community and broader systems of support.
- Support Design: works together with the participant to understand Plan funding and its purpose. Support Coordinator will understand the participant’s confidence and skills and helps them identify what they want from services. Will develop and design support solutions to meet participant outcomes.
- Establish Supports: assist the participant to identify and consider support options, and link them to the broader systems of supports. Where practical, creating a supports and action plan to facilitate the participant to implement their plan.
- Crisis: Assistance to resolve points of crisis and developing capacity and resilience in the participant's network.
- Coach, Refine, Reflect: Coach the participant through challenges that come up. Helps people prepare for review and report on achieved outcomes.
Find a Support Coordinator in my area
What do I need to do if I choose to self-manage?
Great question - and nice work on embracing the NDIS yourself. Self-managing your funds is fairly simple, but must be navigated properly. Keep track of your funding and budgeting by accessing the NDIS site, My Portal.
Fulfil your self-management obligations with detailed invoicing
At the end of a booking, to be NDIS compliant both you and your support worker will need to have copies of an invoice that must include:
- a description of the services
- time stamps
- relevant personal information
There are apps available that help keep everything compliant.
Once they have been working with you for a while, workers will need to complete a goal review ensuring you have up to date, auditable information on how you are tracking to your goals.
How should I prepare for a plan review?
Plan reviews should not be stressful, and have been created so that you get the most out of your plan. You won’t need to pick new goals at every plan review but it’s important that your plan, supports and services help you progress, achieve new things and eventually achieve your long-term goals. Reviews are a great way to tweak what needs changing to send you toward your goals.
Have a look at this checklist to prepare for a plan review.
Things to think about
- Think about what’s been working! What was great AND what didn't work well.
- Ask yourself - have you achieved your goals?
- Did you make progress towards achieving your desired outcomes?
- Which goals do you want to change? Which do you want to continue?
- Think of who can help you achieve your goals.
- Is the NDIS beneficial to you? Will you need it in future?
- Anything else you’d like to change, e.g. plan management.
A report from your provider can be beneficial
It might be the case that you’ll need to provide assessments or reports from your service providers in a plan review meeting. This will give some indication as to how your supports and services are helping you achieve your goals.
In the report, your service providers could recommend activities or services that will be beneficial to you in the future. These suggestions are something you can discuss with your Local Area Coordinator or member of the NDIS. Of course, if things are going great with your plan, you might not need many tweaks or to explore future suggestions.
Note: participants with support needs which are unlikely to change can request plan durations of up to 3 years. This allows for less frequent plan review processes. There are several criteria that will be considered if you do request a longer plan duration including being in a stable situation, having confidence in the funding to achieve your goals, and a focus on longer-term goals like employment.
What will the NDIS fund?
The NDIS was created to provide reasonable and necessary supports and services to eligible participants and to assist in the pursuit of individually outlined goals. These supports and services can cover a number of areas in a person’s life.
To be considered reasonable and necessary, support must be:
- Related to the disability
- Relative value for money
- Likely to work and benefit the participant
The NDIS is guided by the National Disability Insurance Scheme Act 2013 (NDIS Act) which, among other things, outlines what type of supports can be considered “reasonable and necessary”. Some “reasonable and necessary” types of support include:
- certain daily personal activities
- transport that enables participation in community, social, economic and daily life
- workplace assistance that allows a participant to become or stay employed
- therapeutic supports, including behavioural support
- assistance with household tasks that enables participants to maintain their home environment
- home and/or vehicle modifications
- mobility equipment and assistive technology
In all instances, the supports must relate to a participant’s disability and it must be able to be demonstrated that the supports are likely to be beneficial and effective.
How to apply for the NDIS?
First, check the NDIS checklist to see if you are eligible.
If you meet the criteria and you would like to become a participant, call the National Disability Insurance Agency (NDIA) on 1800 800 110 and ask to make an Access Request.
If you are already receiving disability support services, the NDIA will contact you when it becomes available in your area. If you do not receive any disability supports, here are some things to check before you call to make an Access Request:
- NDIS is available in your area
- You are an Australian citizen or hold Permanent Residency or Special Category Visa
- You meet specific disability requirements, or early intervention requirements
As part of the Access Request process, you will be asked:
- to confirm your identity and/or a person's authority to act on your behalf
- questions to see if you meet the NDIS access requirements (age, residence and disability)
- questions about providing consent to enter the NDIS and about seeking information from third parties.
If your request is valid, you’re likely to get a response within 21 days, at which point you may be asked to provide additional information. This may include:
- information about your disability
- how it impacts your day-to-day life.
You can provide copies of existing information, including letters or reports, or you can ask your treating health professional to fill out and sign a form.
From there, your application will be assessed.
What conditions are eligible for NDIS?
The NDIS will support:
- a person with a significant and permanent disability
- a child aged under 7 years old with a disability or developmental delay, who require support or assistance with activities such as self-care, social interaction, learning, communication and/or mobility, and whose condition impacts their ability to carry out tasks.
The National Disability Insurance Agency (NDIA) supplies a list of conditions that could qualify for NDIS eligibility, but it is important to note that these lists are not the only consideration.
When determining eligibility, the NDIS takes into account the impact of any conditions on a person’s functioning, which is on a case-by-case basis.
Here’s the current list as defined by NDIS:
- Intellectual disability diagnosed and assessed as moderate, severe or profound in accordance with current DSM criteria (e.g. IQ 55 points or less and severe deficits in adaptive functioning).
- Autism diagnosed by a specialist multi-disciplinary team, paediatrician, psychiatrist or clinical psychologist experienced in the assessment of Pervasive Developmental Disorders, and assessed using the current Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnostic criteria as having severity of Level 2 (Requiring substantial support) or Level 3 (Requiring very substantial support).
- Cerebral palsy diagnosed and assessed as severe (e.g. assessed as Level 3, 4 or 5 on the Gross Motor Function Classification System - GMFCS).
- Genetic conditions conditions that consistently result in permanent and severe intellectual and physical impairments:
- Angelman syndrome
- Coffin-Lowry syndrome in males
- Cornelia de Lange syndrome
- Cri du Chat syndrome
- Edwards syndrome (Trisomy 18 – full form)
- Epidermolysis Bullosa (severe forms):
- Autosomal recessive dystrophic epidermolysis bullosa
- Hallopeau-Siemens type
- Herlitz Junctional Epidermolysis Dystrophica
- Lesch-Nyhan syndrome
- Leigh syndrome
- Alexander disease (infantile and neonatal forms)
- Canavan disease
- Krabbe disease (globoid cell leukodystrophy) – Infantile form
- Pelizaeus-Merzbacher Disease (Connatal form)
- Lysosomal storage disorders resulting in severe intellectual and physical impairments:
- Gaucher disease Types 2 and 3
- Niemann-Pick disease (Types A and C)
- Pompe disease
- Sandhoff disease (infantile form)
- Schindler disease (Type 1)
- Tay-Sachs disease (infantile form)
- Mucopolysaccharidoses – the following forms:
- MPS 1-H (Hurler syndrome)
- MPS III (San Fillipo syndrome)
- Osteogenesis Imperfecta (severe forms):
- Type II - with two or more fractures per year and significant deformities severely limiting ability to perform activities of daily living
- Patau syndrome
- Rett syndrome
- Spinal Muscular Atrophies of the following types:
- Werdnig-Hoffmann disease (SMA Type 1- Infantile form)
- Dubowitz disease (SMA Type II – Intermediate form)
- X-linked spinal muscular atrophy
- Spinal cord injury or brain injury resulting in paraplegia, quadriplegia or tetraplegia, or hemiplegia where there is severe or total loss of strength and movement in the affected limbs of the body.
- Permanent blindness in both eyes, diagnosed and assessed by an ophthalmologist as follows:
- Corrected visual acuity (extent to which an object can be brought into focus) on the Snellen Scale must be less than or equal to 6/60 in both eyes; or
- Constriction to within 10 degrees or less of arc of central fixation in the better eye, irrespective of corrected visual acuity (i.e. visual fields are reduced to a measured arc of 10 degrees or less); or
- A combination of visual defects resulting in the same degree of visual impairment as that occurring in the above points. (An optometrist report is not sufficient for NDIS purposes.)
- Permanent bilateral hearing loss > 90 decibels in the better ear (pure tone average of 500Hz, 1000Hz, 2000Hz and 4000Hz).
- Deafblindness confirmed by ophthalmologist and audiologist and assessed as resulting in permanent and severe to total impairment of visual function and hearing.
- Amputation or congenital absence of two limbs.
Are things like ADHD covered under the NDIS?
It looks like ADHD - or Attention Deficit Hyperactivity Disorder doesn’t currently qualify as a disability under the NDIS, meaning those with ADHD are unlikely to be eligible unless ADHD is copresenting with another disability.
There’s a broad spectrum of psychosocial disabilities the NDIS does recognise, however. If ADHD is linked to an Autism Spectrum Disorder (ASD), or a different recognised psychosocial disability, then that individual may be eligible for support. If you’re unsure, it’s best to get an assessment in case you, or the person you are enquiring for, are in fact eligible.
You’ll need to fill out a form
The NDIS requires you to fill out an Evidence of Psychosocial Disability form - completed by your most appropriate clinician, and your support worker or appropriate person. This evidence form makes it easier for people with a psychosocial disability and supporters to collect evidence for NDIS eligibility.
Find out about mental health and the NDIS here.
Is there an exit fee I have to pay when I switch providers??
This depends on what was specified in your initial Agreement. Every home care and disability services provider has a different policy and therefore potentially different fees when it comes to switching providers.
Firstly, exit fees are not mandatory.
Depending on your Agreement, it might be deducted from your unspent funds if that was what specified when you signed up. Note that it can only be deducted from your unspent funds if it was fully disclosed in the Agreement you entered into. In 2017, it became mandatory for providers to publish exit fees - which ranged from $5 to $1000. Providers cannot simply charge exit fees if you didn’t agree to it!
If you’re in the process of signing up to a provider, be sure to read about fees and charges you might incur if you choose to leave. Know what you’re agreeing to and signing up for with each agency.
What’s an “admin fee”?
Home care providers charge different fees. We’ll give you a breakdown below.
A case management fee is a monthly fee that ranges anywhere between $50 and $500, depending on the Home Care Package package level. It can cover:
- the costs involved in creating your care plan
- conducting home visits for assessment and review purposes
On top of that, there are admin fees. Typically, administration fees are calculated as a percentage of someone’s Home Care Package. They range from 20% to 45%. An admin fee might cover:
- administering your care plan
- managing your budget
- co-ordinating carers
The fees are not regulated and will vary greatly from one Home Care provider to the next. It used to be the case that some providers had a field day with high administration charges and hidden case management fees - even charging GST where they are not allowed. An imprtant one to still look out for!
Ultimately, fees eat into the funding that participants have for getting support. Before signing up to anything, get a full breakdown of the fees that the provider will charge over time.
What’s a “daily fee”?
Daily fees are charged across the board, but they vary slightly depending on where you are.
Home Care providers add the basic daily fee to your budget, effectively increasing what you are able to spend on support and services. The basic daily fee is a co-contribution paid by Home Care Package users irrespective of the tier level. It is set at 17.5% of the single age pension, now $10.43 a day.
In Aged Care Homes, the daily care fee covers day-to-day costs including meals, laundry, and cleaning services. It is the maximum amount that everyone pays for the day-to-day services they will receive at the home. Based on current rates, this is $51.63 a day.
How does the NDIS work?
NDIS is an acronym that stands for National Disability Insurance Scheme. It was introduced progressively across all states and territories in Australia from 2013, and provides support to eligible people with intellectual, physical, sensory, cognitive and psychosocial disability.
The NDIS Early intervention supports can also be provided for eligible people with disability or children with developmental delay.
It’s the hope of the National Disability Insurance Agency that the scheme gives peace of mind and necessary support to any Australians if they, their child or family member is born with or acquire a permanent disability.
The NDIS is a scheme and operates differently to a welfare system, designed to help people get the support they need so their skills, independence and quality of life improve over time. This is mapped with the creation of a plan specific to each individual that details goals, areas of life that need support, and the way that support needs to be provided.
The NDIS can provide all people with disability with information and connections to services in their communities such as GPs, sporting clubs, support groups, libraries and schools, as well as state-based information.
There is an assessment process in order to meet the criteria of NDIS. Everyone who meets the criteria and is eligible for NDIS funding has a unique plan. A plan is a written agreement that has been detailed and worked out with you detailing
- What services you need and how you want them delivered
- Which areas of life need support
- Goals that you’d like to achieve - goalposts to reference back to over time and things to work towards
The NDIA will work with each person to discern areas of life that require support, as well as nutting out a series of goals you’d like to achieve that guides the outcomes providers will help you work toward. Their aim is to create a plan that provides the right type of support for you. After creating a plan, there are plenty of organisations and resources to help you get started. To check out budgeting options and how to use your funding, check out the MyPlace portal. A guide to accessing the site can be found here. Over time you’ll be able to review your plan to make sure the services and supports you receive are working to support your goals.
How come rates vary in different areas?
It pays to do a bit of research on the rates of support work and aged care services in your town or city, as rates vary greatly. Similarly to every industry, the going rate is driven by competition in the market, how many skilled workers are in your area and ease of access based on where you are located.
If you’re in a densely populated area with lots of demand, rates are likely to be more competitive. Try to find providers with a reasonable price that is along the lines of what other people charge in your area.
A thriving business that charges higher rates may be doing so because of the broader range of services offered - from therapies to nursing and access to swimming pools. Local home care agencies have various overheads and will be able to give you payment rates if you contact them. It’s worth checking out a number of different options and understanding what’s behind the fees and rates.
If a provider seems dodgy, what should I do?
The NDIA is serious about preventing, detecting and dealing with fraud against the Agency and the NDIS.
If you suspect someone may be committing fraud against the NDIA or NDIS you should report it. The National Disability Insurance Agency (NDIA) is interested in hearing your concerns or suspicions, even when what you have noticed may not end up being fraud. Reports can be made anonymously and your rights are protected by law. The best way is to call the Fraud Reporting Hotline on 1800 650 717. Fraud is defined as dishonestly obtaining a benefit or causing a loss by deception or other means.
The NDIS breaks down what to look out for here:
If you have concerns about how a provider conducts business, such as:
- falsification of invoices
- having unsuitable or unqualified personnel providing services
- using NDIA or NDIS branding to mislead participants
- providing supports without the consent of the participant.
If someone is encouraging misuse of funds, issues with spending and/or claiming:
- under-servicing a participant (charging for one hour, but only delivering 40 minutes of support)
- altering the dates of supports provided (e.g. to a weekend) to increase the rate charged
- claiming for supports that were never provided
- charging for one-to-one rates for supports delivered to a group
- claiming for supports provided prior to plan approval
- charging unreasonable amounts/time for travel.
When it comes to being an NDIA Registered Provider, the NDIA wants you to report if you suspect:
- The provision of misleading information in order to obtain registration status (e.g. not holding the appropriate qualifications to provide the services offered, or falsely claiming to hold a higher intensity support qualification than is held).
- Misuse of participant or Agency information
- inappropriate use of personal information without the consent of participant.
- Conflicts of interest
- suspected collusion with other parties (e.g. involving NDIA staff, Partners in the Community etc.) to gain an advantage
- attempts to in inappropriately influence participants to use services which result in a benefit to the provider.
There are a range of behaviours that may seem suspicious, and might end up being a mistake or a misunderstanding (and not fraud). However, to avoid mistakes happening again you should report it.
What information do I need to record on invoices?
For every booking, both you and your support worker need to have detailed invoices for your records. At any point, representatives for the NDIS can do an audit to check that the funding is being spent in alignment with policy and your goals, and that all paperwork is compliant. Invoices will need to have:
- Timestamps, length of shift
- Name, including surname
- and services given - e.g. toileting, grooming, assisted transport
- Plus any other important details or information relevant to that shift.
Make sure you always have all of the details that create the perfect paper trail for NDIS compliance.
Are there minimum times for shifts?
Good service providers should be guided by SCHADS (Social, Community, Home Care and Disability Services) award rates, which means there is a 1 hour minimum for all shifts booked.
Ensure you are aware of what the Award rates are and, if you are hiring independent contractors, be sure to negotiate a price that is fair. Registered Service Providers will also be guided by the NDIS Price Guide, found here. All work completed should be Fair Work compliant.
What if a worker asks me to hire them outside of their workplace?
Know the risks involved for everyone when a worker suggests to be hired outside of an official Agreement or contract.
Firstly, try not to feel pressured. They’re going against the Terms and Conditions they agreed to in their company, and above all else, could create a safety issue for you when people turn up at your door without tracking or record.
Insurance covers bookings when done properly.
When you a provider they work to facilitate the highest standards of safety, care and support which is designed to keep you, and the contractors you book safe.
If a worker decides to offer work outside of their organisation, don’t expect the same standard of support, safety, and reliability that is vital to your wellbeing and to the community. Workers may also face penalties for arranging external payment and have their employment terminated, or their account deactivated (if an online service) for contravening the Terms and Conditions.
With detailed invoicing requirements set by NDIS, accepting services from someone outside the service Agreement could mean that without the proper paper trail, you also risk your payment being suspended. It’s a lot of hassle.
Using official booking processes is to the great benefit of both you and your support worker.
Don’t be pressured if this happens to you. Get in contact with someone at your service provider organisation immediately.
I’m not a participant of the NDIS. Can I still hire support?
Yes! Not everyone who needs home care and support will be eligible for the NDIS. There are lots of other ways you can book and pay for home care and disability services, including:
- insurance funds like TAC
- other government funding
- your own money.
You can also find lots of private service providers who only accept private or alternative forms of payment - found in external listing directories on government sites.
Some organisations prefer to have clients who are NDIS-funded to ensure their records are compliant. While it might take a little more paperwork for providers to accept payment from private payment, most will still welcome you.